5 May 2021
Today, May 5, is the International Day of the Midwife and a new regional program is making life a lot easier for mums, bubs and midwives in the Yorke and Northern Local Health Network (Y&NLHN).
Through the Sustainability Midwifery Caseload Model of Care pilot, midwives are working in partnership with women and families, to provide continuity of care throughout the pregnancy and birth and immediate postnatal period.
The two-year pilot, which supports the five birthing sites in the network - Wallaroo, Crystal Brook, Port Pirie, Clare and Jamestown hospitals - is expected to improve the recruitment and retention of midwives across regional South Australia, as well as the long-term sustainability of regional birthing services. Its success will see the Model of Care implemented across other regions. The Model of Care was designed with input from a broad range of network clinicians and experts across the Yorke and Northern Local Health Network.
Helping to evaluate the success of the program is Pamela Adelson, a Research Fellow at the Rosemary Bryant AO Research Centre. Ms Adelson, an advocate in midwifery-led care, says SA has been a leader in midwifery-led continuity of care, with a doubling in the numbers of women receiving such care in the past two decades.
The Continuity Model of Care is a collaborative arrangement with the midwives, obstetricians and GP obstetricians working in the LHN.
“It was launched in August 2019. Maternity services across regional/rural Australia have essentially halved in the last 25 years and this has consequences across several areas,’’ Ms Adelson says.
“Finding clinicians to work in rural areas was becoming problematic, and so there was this belief that these workforce shortages made birthing ‘unsafe’ and that it was safer for women to actually birth in the city in a hospital.
“This is not necessarily true because most women can safely birth in the country but the outcome of all this is about 60 per cent of rural services in SA have disappeared over the last 25 years and this has a huge impact for women and their families as well as for health care providers who are out there,’’ Ms Adelson says.
“It was very expensive to always have midwives on staff 24/7 at these five hospitals for which there only about 480 births in the region. So this was really a unique model to bring five birthing sites together.
“Overwhelmingly the clinicians are really happy with it, the women love it because they have a known care provider throughout their pregnancy and after the birth and we’ll see what the economics show but I hear that that’s looking very good as well,’’ Ms Adelson said.
“Our preliminary evaluation results show 95 per cent of women said ‘Yes, I would definitely use this model of care’, they were just so happy. Statements like ‘Yes, I was treated with respect, I felt listened to, I could ask questions, and I felt confident with the skills and knowledge of the midwives’ are very encouraging.
“Importantly the collaborative approach is helping clinicians to work together and supporting the attraction and retention of staff for a sustainable service into the future.
“The majority of midwives, about 75 per cent, indicated that they were prepared to work in a regional/rural caseload mode of care or had some experience working in a rural setting.
“All midwives who responded to the evaluation thought the role of the regional caseload midwife as presented in the York and Northern Region MoC was sustainable and would be attractive to other midwives.”
One of the key architects of the program is Elizabeth Bennett, the Yorke and Northern MGP (Midwifery Group Practice) Midwifery Unit Manager.
“The women love it, there are 22 midwives in the group across the five sites and we love what we do. It’s not a job, it’s a vocation, and we’re all very passionate about making sure women have the care that they need and that they understand we can bring their service to them,’’ Mrs Bennett says.
“We do a lot of home visits, antenatally as well, we build a really good partnership with the family so that they trust us and we work collaboratively with the medical officers in all of the five (hospital) sites to ensure we have safe management plans to be able to care for the women.
“The uniqueness of this program that started off as a pilot is that it’s the only MGP in Australia that is a five-site, one governance model of care,’’ Mrs Bennett stated.
“We’ve evaluated what we’ve done and we know that it works. That’s the uniqueness of what we’re trying to do here, look at the one governance and having consistent communication platforms and consistent equipment so that the midwives can work across sites and be able to support midwives in other sites. There are a lot of benefits to what we’re doing.’’
On International Midwives Day we celebrate the vital work midwives do in caring for mums, newborns and families around the world. We also wish them a happy Mother’s Day for Sunday.
This year’s Midwives Day theme is “Follow the Data: Invest in Midwives.” “We look forward to coming together as a global midwife community to advocate for investment in quality midwifery care around the world, improving sexual, reproductive, maternal, newborn, child and adolescent health in the process,’’ says the International Confederation of Midwives.
“We now know that achieving universal health coverage through midwife-led continuity of care could avert 67% of maternal deaths and 64% of newborn deaths by 2035,” ICM President Franka Cadee says.
ANMF (SA Branch) CEO/Secretary Adj Associate Professor Elizabeth Dabars AM has expressed her heartfelt congratulations and appreciation to midwives everywhere.